Neck Pain And Headaches

Headache has been referred to as the commonest complaint of civilized man affecting two thirds of the population. Headaches can be categorized into eight groups the first four of which are seen commonly and the last four less commonly.

Headaches associated with viral illnesses for example the common cold or flu.

Vascular headaches such as migraines or cluster headaches which affect men 20 to 40 years causing excruciating pain behind the eyes and temples.

Tension headaches due to muscle contraction.

Cervical headaches where pain is referred to the head from muscles, joints and fascia of the neck.

Serious headaches caused by brain tumours, brain infections such as meningitis or internal bleeding or haemorrhage.

Exercise related headaches such as footballer’s migraine.

Caffeine or other drug withdrawal, or drug induced headaches.

Trauma and injury to the head eg. falls, and blows.

Cervical and tension headachesare very common and sufferers are often treated by manual therapists such as Osteopaths. They are usually described as a constant steady dull ache which can affect any part of the head or the whole of the head. The patient may describe a pulling or gripping feeling or a tight band like pressure around the head.

Tension headaches typically start at the back of the head where the head and neck meet and commonly travel to the front, temples or behind the eyes. They are commonly associated with neck pain or stiffness and may be aggravated by neck and head movements or by holding the neck in sustained positions such as using computers and mobile phones.

Cervical headaches often come on gradually over weeks. There may have been a previous injury such as whiplash due to a motor vehicle accident. They are often associated with poor posture that usually consists of rounded shoulders, with the head jutting forward and the neck arched back. This posture is a common occurrence in our modern lifestyles with hours of sitting at desks and computers. It causes tightness in the shoulders, in the upper back and in the muscles of the neck. Stress also contributes to this type of headache and aggravates muscle tension and postural abnormalities.

Cervical headaches are mostly caused by irritation to the nerve roots of the upper neck due to damage or restrictions to the joints and ligaments of the upper or lower neck or compression of the nerves as they pass through the deep muscles.

Tension headaches with pain in the front and temporal part of the head may also be commonly caused by trigger points. Trigger points are small hyper irritable spots in tight bands of muscle that cause referred pain to specific areas and are found in all people with chronic musculoskeletal pain. These are often found in the upper shoulder muscles, and muscles in the front and back of the neck and often cause headaches.

Treatment by Osteopaths involves examination of the joints, muscles and neural structures of the neck region and postural assessment and screening of other areas for imbalances that may be contributing to tension in the neck including the thoracic spine shoulders, lower back and pelvis. Treatment aims to improve the overall function of the area by improving joint mobility through reducing muscle and fascial tension through mobilisation and the application of a variety of soft tissue techniques. After treatment postural and ergonomic advice may be given. Specific self treatment exercises may also be given to help maintain a strong flexible posture and reduce tension in the shoulders, upper back and joints and muscles in the neck muscles.

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